Роль антимюллерового гормону в діагностиці та менеджменті овуляторних дисфункцій. Фокус на синдром полікістозних яєчників

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that significantly impacts reproductive health, quality of life, and increases cardiometabolic and oncological risks for women and their offspring. It also still poses a challenge for timely diagnosis and effective treatment.The objective: to determine the differences in anti-Müllerian hormone (AMH) level in women without obesity of early and active reproductive age with the most common form of PCOS (phenotype A), compared to normal ovulatory women matched for age, body mass index (BMI), and social and economic status.Materials and methods. It is a retrospective case-control study. Data from women aged 20–35 years with PCOS phenotype A (oligo-anovulation, hyperandrogenism, polycystic ovarian morphology according to the Rotterdam criteria, 2003) with a normal BMI (18.5–24.9 kg/m2), after excluding other causes, were analyzed (n = 40). The control group (CG) consisted of normo-ovulatory, normal androgenic women with normal ovarian morphology, matched for main parameters (n = 25). AMH level was determined using an automated, biotin-independent chemiluminescent immunoassay (Beckman Coulter DXI 800 analyzer) on the 3rd–5th day of the menstrual cycle in DILA laboratory. Statistical analysis included descriptive statistics, the Mann–Whitney U test, and Spearman’s (rs) and Pearson’s (rp) correlation coefficients. The study was approved by the Bioethics Committee.Results. The mean AMH level in the PCOS group was 10.53 ± 5.34 ng/mL, which was statistically significantly higher (U = 845.00; p ≈ 3.39 × 10−6) compared to the CG, in which the mean AMH level was 5.79 ± 2.47 ng/mL, this is consistent with literature data. No statistically significant correlation between AMH and age was found in the PCOS group (rs = −0.141; p = 0.386), whereas a moderate negative correlation was established in the CG (rs = −0.407; p = 0.043). In women with PCOS and normal BMI, a weak negative correlation between AMH and BMI was determined (rs = −0.272; p = 0.090); while in the CG group, the association was weak positive and non-significant (rs = 0.218; p = 0.295). Asymmetry in the distribution of AMH levels was found, especially in the PCOS group.Conclusions. The study confirmed significantly higher AMH levels in women with PCOS (phenotype A, normal BMI) compared to the CG and the absence of a typical negative correlation between AMH and age in these patients. A significant asymmetry in the distribution of AMH levels was found in the PCOS group. The obtained results underscore the potential value of AMH in the diagnosis and management of women with PCOS and indicate the need for further research to establish threshold AMH values for different PCOS phenotypes, considering BMI, age, and clinical severity of the syndrome. Expanding the accessibility of PCOS diagnosis is crucial, given its impact on the reproductive and overall health of women and their offspring, especially in today’s Ukrainian context.